不良生活事件暴露模式与慢性肾脏病风险之间的关系:对 140,997 人进行的前瞻性队列研究。

IF 5.8 1区 医学 Q1 PSYCHIATRY
Chunyang Li, Jie Chen, Yilong Chen, Chao Zhang, Huazhen Yang, Shaobin Yu, Huan Song, Ping Fu, Xiaoxi Zeng
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引用次数: 0

摘要

不良生活事件与躯体疾病有关。这项研究旨在评估不同生命阶段的不良事件与慢性肾脏病(CKD)风险之间的关系。这项前瞻性队列研究包括来自英国生物库的 140,997 名参与者。利用与童年虐待、成年期逆境和灾难性创伤相关的调查项目,我们进行了潜类分析,总结出了五种不同的不良生活事件暴露模式,即 "低水平暴露"、"童年期暴露"、"成年期暴露"、"性虐待 "和 "儿童至成年期暴露"。我们采用 Cox 比例危险回归评估不良生活事件暴露模式与 CKD 的关系,采用基于回归的中介分析分解总效应,并采用全基因环境交互作用研究(GEWIS)确定基因位点与不良生活事件之间的交互作用。在中位 5.98 年的随访期间,共发现了 2734 例慢性肾功能衰竭病例。与 "低水平暴露 "模式相比,"儿童至成年期暴露 "与慢性肾脏病风险增加有关(危险比为1.37,95% CI为1.14至1.65)。体重指数、吸烟和高血压分别占总影响的 11.45%、9.79% 和 4.50%。其他模式没有显示出明显的结果。GEWIS 和后续分析表明,不良生活事件与慢性肾脏病之间的关联程度因基因多态性而异,并确定了潜在的潜在途径(如白细胞介素 1 受体活性)。这些发现强调了将个人的心理遭遇和遗传特征纳入 CKD 精准预防的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The association between patterns of exposure to adverse life events and the risk of chronic kidney disease: a prospective cohort study of 140,997 individuals.

Exposure to adverse life events is linked to somatic disorders. The study aims to evaluate the association between adverse events at varying life stages and the risk of chronic kidney disease (CKD), a condition affecting about 10% population worldwide. This prospective cohort study included 140,997 participants from the UK Biobank. Using survey items related to childhood maltreatment, adulthood adversity and catastrophic trauma, we performed latent class analysis to summarize five distinct patterns of exposure to adverse life events, namely "low-level exposure", "childhood exposure", "adulthood exposure", "sexual abuse" and "child-to-adulthood exposure". We used Cox proportional hazard regression to evaluate the association of patterns of exposure to adverse life events with CKD, regression-based mediation analysis to decompose the total effect, and gene-environment-wide interaction study (GEWIS) to identify interactions between genetic loci and adverse life events. During a median follow-up of 5.98 years, 2734 cases of incident CKD were identified. Compared with the "low-level exposure" pattern, "child-to-adulthood exposure" was associated with increased risk of CKD (hazard ratio 1.37, 95% CI 1.14 to 1.65). BMI, smoking and hypertension mediated 11.45%, 9.79%, and 4.50% of this total effect, respectively. Other patterns did not show significant results. GEWIS and subsequent analyses indicated that the magnitude of the association between adverse life events and CKD differed according to genetic polymorphisms, and identified potential underlying pathways (e.g., interleukin 1 receptor activity). These findings underscore the importance of incorporating an individual's psychological encounters and genetic profiles into the precision prevention of CKD.

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来源期刊
CiteScore
11.50
自引率
2.90%
发文量
484
审稿时长
23 weeks
期刊介绍: Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.
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